Impact of Enhanced Recovery After Surgery (ERAS) Protocols on Patient Outcomes in Laparoscopic Hysterectomy
Keywords:
Enhanced Recovery After Surgery, hysterectomy, postoperative recovery, pain management, hospital stay, complications, ERAS protocolsAbstract
Background: Enhanced Recovery After Surgery (ERAS) pathways combine evidence-based perioperative interventions intended to reduce surgical stress and accelerate functional recovery, but evidence from resource-constrained gynecological practice remains limited. Objective: To compare perioperative outcomes after elective laparoscopic hysterectomy under ERAS and conventional care pathways. Methods: This prospective, non-randomized comparative study included 90 women aged 40–60 years undergoing elective laparoscopic hysterectomy at Doctors Hospital and Medical Center, Lahore, during September–October 2024. Forty-five patients received ERAS care and 45 received conventional care. Baseline, intraoperative, recovery, pain, opioid-consumption, length-of-stay, and complication outcomes were compared using independent-samples t tests, Mann–Whitney U tests, and categorical tests as appropriate. Results: ERAS was associated with shorter mean operative duration (93.98 ± 9.73 vs 108.56 ± 7.67 minutes; mean difference −14.58, 95% CI −18.25 to −10.91), lower mean intravenous-fluid use (1814.1 ± 183.2 vs 2190.7 ± 163.3 mL; mean difference −376.6, 95% CI −449.3 to −303.9), lower median blood loss (303 vs 371 mL), and shorter median hospital stay (2.8 vs 5.7 days; all p<0.001). Pain scores at 6, 24, and 48 hours and total opioid consumption were lower with ERAS (all p<0.001). Nausea/vomiting, urinary-tract infection, and fever were also less frequent. Conclusion: In this single-center observational comparison, ERAS care was associated with faster postoperative recovery, reduced resource use, and fewer selected complications after laparoscopic hysterectomy. Keywords: Enhanced recovery after surgery, Hysterectomy, Laparoscopy, Postoperative recovery, Multimodal analgesia, Length of stay
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